Biomedical subjects

Jan Neuman

Publications and source records attributed to Jan Neuman.

3 recordsLinked to original sources

PubMed2005

A reliable coding system to define screening prostate-specific antigen tests was developed in a case-control study.

OBJECTIVE: To establish the reliability of a coding system for screening and diagnostic prostate-specific antigen (PSA) testing from patient charts. STUDY DESIGN AND SETTING: Two investigators reviewed 448 chart abstractions from a population-based case-control study of PSA screening in the Toronto area. The tests evaluated for reliability were transrectal ultrasound (TRUS), digital rectal examination (DRE), and prostate-specific antigen (PSA). RESULTS: DRE results were found in 87%, PSA results in 65%, and TRUS results in 12% of the 749 charts. Interobserver agreement was 94% for DRE texture (kappa =.885), 95% for DRE asymmetry (kappa = .868), 85% for DRE physician interpretation (kappa = .698), 97% for final DRE result (kappa = .856), and 87% for TRUS (kappa = .769). Physician interpretation modified the final result in only 6.2% of DREs. Interobserver agreement for PSA coding was 91% (kappa = .787). Of PSA results, pure PSA screening with no symptoms of obstructive urination was found in 19%, symptomatic PSA screening in 46%, and diagnostic PSA testing in 35%. CONCLUSION: We have developed a practical and reliable coding system for TRUS, DRE, and PSA in the context of a case-control study of PSA screening.

Biomarkers, Tumor↗

PubMed2005

Psychological side-effects of clomiphene citrate and human menopausal gonadotrophin.

OBJECTIVE: This study evaluated the psychological side-effects of clomiphene citrate (CC) and hMG in women undergoing fertility treatment. METHOD: This study was a cross-sectional, self-report survey of 454 women at various stages of treatment for infertility. At the time of study, 139 women had not taken fertility drugs and 315 women had taken one or more cycles of CC or hMG. All subjects were asked to complete the State-Trait Anxiety Inventory (STAI). Women taking CC or hMG were also asked to complete a self-administered questionnaire on the side-effects of their medications. RESULT(S): In the CC group (n = 162) and hMG group (n = 153), 77.8% (126 of 162) and 94.8% (145 of 153) reported at least one side-effect, respectively. Irritability, mood swings, feeling down, and bloating had high frequencies in both CC and hMG groups, with a higher mean number of side effects reported in the hMG group (4.4 +/- 3.7 for the CC group and 6.8 +/- 3.7 for the hMG group, p < 0.001). There was no significant difference among the CC, hMG and no medication groups for mean state and trait anxiety scores. However, there were significant differences among the three side-effect groups (those who reported 1 to 4, 5 to 7, and more than 7 side-effects) for the mean scores of state (df = 2, F = 8.7, p < 0.001) and trait (df = 2, F = 11.9, p < 0.001) anxiety in women taking fertility drugs. CONCLUSION(S): Women taking CC or hMG reported high frequencies of psychological side-effects, and should be advised of these before treatment.

Anxiety↗

PubMed2005

Screening with prostate specific antigen and metastatic prostate cancer risk: a population based case-control study.

PURPOSE: Screening of asymptomatic men with prostate specific antigen (PSA) remains a controversial issue. There is limited evidence that screening is effective in reducing mortality from prostate cancer. In the current study we determined if screening with PSA reduces the risk of metastatic prostate cancer. MATERIALS AND METHODS: We conducted a population based case-control study among the residents of Metropolitan Toronto and 5 surrounding counties in Ontario, Canada. Data were obtained from 236 cases of metastatic prostate cancer and 462 controls randomly sampled from the source population and frequency matched to cases for age and area of residence. History of PSA testing, digital rectal examination, symptoms and other data were obtained from medical records and a self-administered questionnaire. The association between PSA screening and metastatic prostate cancer was measured by the Mantel-Haenszel odds ratio stratified by exposure observation time and other potential confounding factors. RESULTS: In asymptomatic men, the frequency of PSA screening as determined from medical records was significantly lower among the cases compared with the controls (odds ratio 0.65, 95% confidence interval 0.45 to 0.93). The odds ratio was 0.52 (0.28 to 0.98) in men 45 to 59 years old and 0.67 (0.41 to 1.09) in those 60 to 84 years old. CONCLUSIONS: In this case-control study screening of asymptomatic men with PSA was associated with a significantly reduced risk of metastatic prostate cancer. The results need to be confirmed in randomized controlled trials.

Aged↗